Background
The use of e-cigarettes is increasing globally, particularly among young adults. Although several use them to quit smoking, their effects are controversial. The Fagerstrom Test for Nicotine Dependence (FTND) was used to assess nicotine dependence in the smoking cessation process. This study examined changes in FTND scores among young adults using different types of cigarettes over a 1-year period.
Methods
Prospective cohort data were collected from cigarette users at higher education institutions in the lower northern region of Thailand to analyze changes in FTND scores over a 1-year period. E-cigarette users and combined users were compared with conventional cigarette users. A marginal structural model (MSM) with an inverse probability of weighting (IPW) was used to adjust for time-dependent and time-independent confounders.
Results
Of the 133 participants, 58 were e-cigarette users (43.6%), 33 were combined cigarette users (24.8%), and 42 were conventional cigarette users (31.6%). The results revealed that when both time-dependent and time-independent confounders were adjusted using MSM with IPW, e-cigarette users had a 0.20 decrease in the mean FTND score, and combined users had a 0.47 decrease in the mean FTND score compared to conventional cigarette users. However, the difference was not statistically significant.
Conclusion
The use of e-cigarettes or combined cigarettes did not significantly affect nicotine dependence levels in young adults over a 1-year period. Consequently, e-cigarettes should not be recommended to reduce nicotine dependence among young adult cigarette users. Further studies are required to determine whether e-cigarettes affect smoking cessation rates.

Background
Many people use both combustible cigarette (CC) and electronic cigarette (EC). We compared nicotine dependence among CC, EC, and dual users using questionnaires and urinary cotinine levels.
Methods
Data from the Korea National Health and Nutrition Examination Survey (2014–2017) databases were analyzed; 3,917 CC, EC, and dual users were administered the urinary cotinine test, and 1,045 current CC and dual users completed the Heaviness of Smoking Index (HSI) questionnaires. Weighted geometric means of urine cotinine levels were compared between exclusive CC, exclusive EC, and dual users. The distribution rate, based on time to first cigarette (TTFC), cigarettes per day (CPD), and the HSI was analyzed in two weighted groups, exclusive CC and dual users.
Results
Among those who currently use any type of cigarette, 89.4%, 1.4%, and 9.2% were exclusive CC, exclusive EC, and dual users, respectively. Weighted geometric means of urine cotinine were highest in dual users (1,356.4 ng/mL), followed by exclusive CC (1,270.3 ng/mL), and exclusive EC (867.7 ng/mL) with significant differences between all three groups (P<0.05). There were no statistically significant differences in CPD between exclusive CC and dual users (P=0.626). The proportion of TTFC ≤5 minutes was 21.5% and 29.5% in the two groups, respectively (P=0.010); however, HSI differences in the two groups was marginal (P=0.557).
Conclusion
In this study, the urinary cotinine value could distinguish the three groups, CC, EC, and dual users, but the questionnaire using HSI could not distinguish the three groups.

Citations

• Protocol for the development of a vaping cessation intervention for young adult veterans
  Neal Doran, Samantha Hurst, Jie Liu, Omar El-Shahawy, Mark Myers, Paul Krebs
  Contemporary Clinical Trials Communications.2024; 39: 101309.     CrossRef
• Smoking Cessation Treatment in Primary Care
  Hye-ji An, Cheol-Min Lee, Yoo-Bin Seo, Eon-Sook Lee, Yu-Jin Paek
  Korean Journal of Family Practice.2024; 14(4): 184.     CrossRef
• Optimum Urine Cotinine and NNAL Levels to Distinguish Smokers from Non-Smokers by the Changes in Tobacco Control Policy in Korea from 2008 to 2018
  Eun Young Park, Min Kyung Lim, Eunjung Park, Yoonjung Kim, Dohoon Lee, Kyungwon Oh
  Nicotine & Tobacco Research.2022; 24(11): 1821.     CrossRef
• Current status of tobacco use, cessation and control policy in Korea
  Cheol Min Lee
  Journal of the Korean Medical Association.2022; 65(12): 789.     CrossRef
• Current status of health promotion in Korea
  Soo Young Kim
  Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
• Recent Trends of Research and Guidelines on Pharmacotherapy for Smoking Cessation
  Choon-Young Kim
  Journal of the Korean Society for Research on Nicotine and Tobacco.2022; 13(4): 107.     CrossRef
• Nicotine Dependence of Electronic Cigarette, Dual Combustible and Electronic Cigarette Users
  Jungun Lee
  Korean Journal of Family Medicine.2021; 42(3): 189.     CrossRef
• Recent Updates of Pharmacotherapy for Smoking Cessation
  Ju Sam Hwang, Cheol Min Lee
  Korean Journal of Family Practice.2021; 11(6): 403.     CrossRef

Citations

• Alcohol and Nicotine Dependence and Time to Death in a General Adult Population: A Mortality Cohort Study
  Ulrich John, Hans-Jürgen Rumpf, Monika Hanke, Christian Meyer
  European Addiction Research.2023; 29(6): 394.     CrossRef
• Association of demographic variables and smoking habits with the severity of lung function in adult smokers
  Arash Toghyani, Somayeh Sadeghi
  Journal of Research in Medical Sciences.2022; 27(1): 18.     CrossRef
• Association between Time to First Cigarette and Health-Related Quality of Life of Middle-Aged Male Current Smokers: A Nationwide Representative Study in Korea
  Sung Eun Jo, Hye Rim Hwang, Yun Jin Kim, Sang Yeoup Lee, Jeong Gyu Lee, Yu Hyeon Yi, Young Hye Cho, Young Jin Tak, Seung Hun Lee, Eun Ju Park, Youngin Lee
  Korean Journal of Family Medicine.2021; 42(3): 225.     CrossRef
• Time to First Cigarette and Self-Reported Health Among US Adult Smokers
  Baksun Sung
  Tobacco Use Insights.2019;[Epub]     CrossRef
• Effects of smoking on the lower respiratory tract microbiome in mice
  Rui Zhang, Ling Chen, Lei Cao, Kang-jie Li, Yao Huang, Xiao-qian Luan, Ge Li
  RESPIRATORY RESEARCH.2018;[Epub]     CrossRef

Background
Recently, a variety of cigarettes which contain a low content of nicotine are on the market and the nicotine tends to be reduced continuously. However, studies have not yet fully demonstrated that low-nicotine cigarettes are subservient to quitting smoking. This study was designed to investigate the effects of the nicotine content on smoking attitudes and on the factors associated with successful smoking cessation. Methods: One hundred twenty-fi ve adult smokers, who had undergone a health examination in a general hospital, had their carbon monoxide measured after responding to the questionnaire. The items of questionnaire consisted of the duration of smoking, the age of starting to smoke, the number of attempts to stop smoking, recognition of nicotine dependence, and nicotine dependence score. Results: The subjects consisted of two groups. One group was low nicotine group and the nicotine content was lower than 0.35 mg per cigarette. The other group was high nicotine group and the nicotine content was over 0.35 mg per cigarette. he age was younger and duration of smoking was shorter in low nicotine group. Monthly income, last schooling and number of attempts to stop smoking were higher in low nicotine group. There was no statistical signifi cant differences between the two groups in the frequency of alcohol drinking, the age of starting to smoke, marital status, nicotine dependence, carbon monoxide concentration and recognition of nicotine dependence. Conclusion: As there was no differences in smoking habits which has infl uence on achieving quit smoking of low nicotine group, we made our conclusion that low nicotine cigarette might be unhelpful in quit smoking.

Background
The Fagerstrom Test for Nicotine Dependence (FTND) is a widely used six-item questionnaire. Its completion require a few minutes, but such time may be too much for busy clinicians and large epidemiologic surveys. The goals of this study was to compare the sensitivity and the specificity of Heavy Smoking Index (HSI) of high nicotine dependence. Methods: The FTND was administered to 943 current smokers from a smoking-cessation clinic in Gwangjin-gu, Seoul. The HSI which combines two items of the FTND (the number of cigarettes per day and the time of the first cigarette of the day) was compared to the FTND. We measured cigarette per day, duration of smoking, and age of smoking initiation. Results: A cutoff score equal or greater than 4 on the HSI detected a similar rate of nicotine dependence as a cutoff score equal or greater than 6 on the FTND. The HSI showed a sensitivity of 88.0% and a specificity of 86.5%. The concordance between the two instruments was high (kappa= 0.74). Conclusion: The HSI was proven to be very useful. If HSI had a proper validity, the HSI can be a good standard of high nicotine dependence for busy clinician and epidemiologists. (J Korean Acad Fam Med 2008;29:405-411)

Background
This study investigated the relationship between stress and nicotine dependence, dividing stress into external stress and internal response. Methods: The subjects were 263 male adults who had visited the General Health Promotion Center at Chungnam National University Hospital in Korea between April and June 2005. Nicotine dependence, external stress and internal response were measured by the Fagerstrom test for nicotine dependence, life change unit of the social readjustment rating scale and the brief encounter psychosocial instrument. Results: The mean (±SD) score of external stress in smokers (n=107) was 150.79 (±109.02), which was significantly (P<0.001) higher than 92.96 (±126.27) in non- smokers, and the mean (±SD) score of internal response in smokers was 10.30 (±3.16), which was also significantly (P<0.001) higher than 8.71 (±3.33) in non- smokers. The smokers' nicotine dependence showed positive correlation with the score of external stress (r=0.436, P<0.001) and the score of internal response (r=0.579, P<0.001). The stepwise multiple regression analysis showed that nicotine dependence was related to the score of internal response, the score of external stress, the duration of education, the age of first smoking (overall R²=0.433, P=0.040), and most closely to the score of internal response (partial R²=0.335, P<0.001). Conclusion: In order to develop an effective strategy for quitting smoking, the internal response to stress needs to be considered as one of evaluation items. (J Korean Acad Fam Med 2007;28:604-609)

Background
: Although the Fagerstrom Tolerance Questionnaire (FTQ) and the Fagerstrom Test for Nicotine Dependence (FTND), which are the tools to measure Nicotine Dependence, have a high internal reliability and a high test-retest reliability, they have not been tested domestically. A Korean-Version Questionnaire for Nicotine Dependence was assessed to find out the internal reliability, test-retest reliability and validity.

Methods : The research subjects were adult smokers of ages between 19 and 77 among hospital visitors, hospital staffs, inpatients and outpatients. The smokers had their carbon monoxide measured after responding to the questionnaire. The questionnaire consisted of Nicotine Dependence (FTQ & FTND), the history of smoking, the variables related to Nicotine Dependence, and factors that influence carbon monoxide(CO) measurement. Micro II smokerlyzer (Bedfont Instruments Ltd, England) was used to analyze CO concentration in expired air. The method used for measuring CO concentration was to deeply inhale and hold one's breath for 15 seconds and measure CO concentration while exhaling.

Results : The total number of subjects was 205 (199 males, 6 females) consisting of 124 hospital visitors, 67 hospital staff, 8 inpatients, and 6 inpatients. The average FTQ was 4.68 and the average FTND was 3.95. Cronbach's alpha, which indicates the internal reliability, was 0.6679 for FTQ and 0.6913 for FTND. The correlation coefficient which indicates test-retest reliability was 0.783 for FTQ and 0.880 for FTND. The correlation coefficient which indicates the relationship between the level of Nicotine Dependence and expired air CO concentration was 0.484 for FTQ and 0.563 for FTND. The correlation coefficient of the smoking period was 0.247 for FTQ and 0.252 for FTND.

Conclusion : This Korean-Version Questionnaires for Nicotine Dependence (FTQ & FTND) were both satisfactory from the aspects of reliability and validity. It was concluded that the Korean-Version of FTND was a reliable method to reflect the level of nicotine dependence of smokers from the fact that the reliability and validity of FTND was higher than that of FTQ.

Background
: Smoking is the single most important factor of the prevention of diseases and the promotion of health. The objectives of this study are to compare the health-related quality of life and other factors between the adult male smokers and nonsmokers.

Methods : Study subjects were selected from the parents of students of three schools; one elementary school, one middle school, and one high school in Suwon city , Kyungki- Do. Among 2.308 respondents to the questionnaire, 1.127 were analyzed.
The questionnaire consisted of questions of general socioeconomic status, health-related quality of life questionnaire, Fagerstrom nicotine tolerance questionnaire, and the Why test.

Results : There were no significant socioeconomic differences between the smokers and nonsmokers except religion(p=0.000). The smoking rage of the subjects was 66.2%, the average amount smokers ranked lower scores in all scales of the health-related quality of life than nonsmoker. The health-related quality of life of the group of high nicotine dependence was low in comparison with the group of low nicotine dependence. The most common reason of smoking was to relieve tension.

Conclusion : Smokers ranked lower scores in all scales of the health-related quality of life than nonsmoker.